Longer Operative Time for Lower Extremity Bypass Surgery is Associated With Inferior Outcomes.

Introduction: This study aims to assess the association of operative time with the postoperative length of stay and unplanned return to the operating room in patients undergoing femoral to below knee popliteal bypasses, stratified by autologous vein graft or polytetrafluoroethylene (PTFE).

Materials And Methods: A retrospective analysis of vascular quality initiative database (2003-2021). The selected patients were grouped into the following: vein bypass (group I) and PTFE (group II) patients.

The implications of surgeon case volume and hospital volume on outcomes of aortobifemoral bypasses in obese patients.

Background: Aortobifemoral (ABF) bypass is the gold standard for treating symptomatic aortoiliac occlusive disease. In the era of heightened interest in the length of stay (LOS) for surgical patients, this study aims to investigate the association of obesity with postoperative outcomes at the patient, hospital, and at surgeon levels.

Methods: This study used the Society of Vascular Surgery Vascular Quality Initiative suprainguinal bypass database from 2003 to 2021.

Patients from distressed communities are more likely to be symptomatic at endovascular aneurysm repair and have an increased risk of being lost to long-term follow-up.

Background: Endovascular aortic aneurysm repair (EVAR) has become the preferred modality to repair abdominal aortic aneurysms (AAAs). However, the effect of the distressed communities index (DCI) on the outcomes of EVAR is still unknown. In the present study, we investigated the effect of DCI on the postoperative outcomes after EVAR.

Fenestrated endovascular abdominal aortic aneurysm repair in octogenarians is associated with higher mortality and an increased incidence of nonhome discharge.

Objective: Fenestrated endovascular abdominal aortic aneurysm repair (FEVAR) has been increasingly becoming the endovascular treatment of choice for patients with juxtarenal abdominal aortic aneurysms with an infrarenal neck, not suitable for traditional endovascular abdominal aortic aneurysm repair. Older patients are at a high risk of developing complications after elective procedures. A review of the literature showed mixed results for FEVAR in the elderly patient population.

Endovascular repair of a cadaveric vascular allograft nonanastomotic pseudoaneurysm.

Patients who have undergone revascularization with a cryopreserved cadaveric arterial allograft (CCAA) require lifelong surveillance because of the risk of allograft failure. The reported long-term complications of these grafts include thrombosis, anastomotic pseudoaneurysm, and graft disruption. We have described a case in which a CCAA developed a nonanastomotic pseudoaneurysm at the site of a previously ligated branch vessel and was repaired using a covered stent graft.

A prospective community engagement initiative to improve clinical research participation in patients with peripheral artery disease.

Objective: Patients diagnosed with peripheral artery disease are difficult to recruit into clinical trials. However, there is currently no high-quality, patient-centered information explaining why peripheral artery disease patients choose to participate or not participate in clinical research studies.

Methods: The current study was a prospective community engagement initiative that specifically asked patients with and without peripheral artery disease: (1) what motivates them to participate in clinical research studies, (2) their willingness to participate in different research procedures, (3) the barriers to participation, (4) preferences about study design, and (5) demographic and disease-related factors influencing participation.

Factors associated with symptomatic postoperative myocardial infarction after endovascular aneurysm repair.

Objective: Endovascular aneurysm repair (EVAR) has now become the most common operation to treat abdominal aortic aneurysms (AAAs). One of the perceived benefits of EVAR over open AAA repair is reduced incidence of perioperative cardiac complications and mortality. The purpose of this study was to determine risk factors associated with postoperative myocardial infarction (POMI) in patients who have undergone EVAR.

Open surgical ligation of a symptomatic mycotic aneurysm of the peroneal artery.

A mycotic peroneal artery aneurysm (MPAA) is a rare diagnosis. We describe a case of a patient with active fungal endocarditis who developed right lower extremity pain. Imaging demonstrated that this patient had an MPAA.

Recanalization of previously thrombosed type II endoleak with aneurysm sac expansion after systemic thrombolysis.

Patients who have undergone endovascular aneurysm repair (EVAR) need lifelong monitoring because of the risk of aneurysm rupture secondary to delayed endoleaks. Thrombolytic therapy may expose patients with previous EVAR to the risk for development of new endoleaks. We describe a case in which a single dose of intravenous tissue plasminogen activator for acute ischemic stroke was complicated by aneurysm sac expansion secondary to a recurrent endoleak.

Peripheral revascularization attenuates the exercise pressor reflex and increases coronary exercise hyperemia in peripheral arterial disease.

Peripheral arterial disease (PAD) is associated with augmented blood pressure (BP) and impaired coronary blood flow responses to exercise, which may increase cardiovascular risk. We investigated the effects of leg revascularization on the BP and coronary blood flow responses to exercise in PAD. Seventeen PAD patients (11 men, 66 ± 2 yr) performed single-leg plantar flexion exercise 24 h before and 1 mo following leg revascularization.

Blood pressure and calf muscle oxygen extraction during plantar flexion exercise in peripheral artery disease.

Peripheral artery disease (PAD) is an atherosclerotic vascular disease that affects 200 million people worldwide. Although PAD primarily affects large arteries, it is also associated with microvascular dysfunction, an exaggerated blood pressure (BP) response to exercise, and high cardiovascular mortality. We hypothesized that fatiguing plantar flexion exercise that evokes claudication elicits a greater reduction in skeletal muscle oxygenation (SmO) and a higher rise in BP in PAD compared with age-matched healthy subjects, but low-intensity steady-state plantar flexion elicits similar responses between groups.

Coronary Exercise Hyperemia Is Impaired in Patients with Peripheral Arterial Disease.

Background: Peripheral arterial disease (PAD) is an atherosclerotic vascular disease that affects over 200 million people worldwide. The hallmark of PAD is ischemic leg pain and this condition is also associated with an augmented blood pressure response to exercise, impaired vascular function, and high risk of myocardial infarction and cardiovascular mortality. In this study, we tested the hypothesis that coronary exercise hyperemia is impaired in PAD.

Revisional bariatric surgery: who, what, where, and when?

Background: Revisional bariatric surgery (RBS) outcomes have been poorly characterized. We compared the RBS and primary bariatric surgery (PBS) outcomes at the Penn State Milton S. Hershey Medical Center in the United States.

Nuclear factor-kappaB mediates the inhibitory effects of tumor necrosis factor-alpha on growth hormone-inducible gene expression in liver.

TNF inhibits serine protease inhibitor 2.1 (Spi 2.1) and IGF-I gene expression by GH in CWSV-1 hepatocytes.